耳穴疗法联合艾司唑仑对老年性痴呆并睡眠障碍患者睡眠结构及认知功能的影响

夏叶子; 沈洁红; 施能能; 李晓静

doi:10.16766/j.cnki.issn.1674-4152.004289

耳穴疗法联合艾司唑仑对老年性痴呆并睡眠障碍患者睡眠结构及认知功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.004289

夏叶子¹,
沈洁红¹,
施能能^{1, 2},
李晓静^1, ,

1.
宁波大学附属第一医院老年医学科，浙江宁波 315000
2.
宁波大学医学院，浙江宁波 315000

基金项目:

浙江省中医药科技计划项目 2024ZL910

详细信息

通讯作者:
李晓静，E-mail：eta_lee@hotmail.com

中图分类号: R749.16 R592
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- 文章访问数: 4
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出版历程
- 收稿日期: 2025-05-28
- 网络出版日期: 2026-03-13

Effects of auricular therapy combined with estazolam on sleep architecture and cognitive function in patients with senile dementia and sleep disorders

1.
Department of Geriatrics, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang 315000, China

摘要

摘要: 目的为探讨老年性痴呆患者的睡眠障碍问题，本研究对比耳穴疗法联合艾司唑仑与单一应用耳穴疗法、单一应用艾司唑仑的应用效果，并探究3种方式对患者睡眠结构、认知功能及相关血清学指标水平的影响，以期为临床治疗老年性痴呆并睡眠障碍提供新思路。方法选取2024年1月—2025年3月宁波大学附属第一医院收治的120例老年性痴呆并睡眠障碍患者，采用简单随机化分组法分为耳穴A组(上午刺激0.5 h)、耳穴B组(下午刺激0.5 h)、艾司唑仑组、联合组(耳穴疗法联合艾司唑仑)，各30例，比较4组睡眠结构、认知功能、血褪黑素(MT)、皮质醇(COR)、5-羟色胺(5-HT)水平及不良反应。结果治疗后联合组的觉醒指数(AI)低于另外三组，睡眠效率指数(SEI)、快速眼动睡眠时间(REM)占总睡眠时间(TST)百分比高于另外三组(P＜0.05)；治疗后联合组MMSE评分[(23.78±1.20)分]高于另外三组[(19.65±1.15)分、(19.70±1.08)分、(16.36±1.42)分, F=219.809，P＜0.001]；治疗后联合组MT、5-HT水平高于另外三组，COR水平低于另外三组(P＜0.001)；4组不良反应发生率比较差异无统计学意义(P=0.309)。结论耳穴疗法联合艾司唑仑有利于提升患者睡眠质量、改善认知功能以及调节MT、COR、5-HT水平，可用于老年性痴呆并睡眠障碍患者的治疗。
- 老年性痴呆 /
- 睡眠障碍 /
- 艾司唑仑 /
- 耳穴疗法 /
- 睡眠结构 /
- 认知
Abstract: Objective To address sleep disorders in patients with senile dementia, this study compared the therapeutic effects of auricular therapy combined with estazolam versus auricular therapy or estazolam monotherapy, and investigated the effects of the three treatment methods on sleep architecture, cognitive function, and relevant serological indicators, aiming to provide new insights for clinical treatment of senile dementia complicated with sleep disorders. Methods A total of 120 patients with senile dementia and sleep disorders admitted to the First Affiliated Hospital of Ningbo University from January 2024 to March 2025 were selected and randomly divided into the auricular therapy group A (30-min stimulation in the morning), the auricular therapy group B (30-min stimulation in the afternoon), the estazolam group, and the combination group (auricular therapy combined with estazolam), with 30 cases in each group. Sleep architecture, cognitive function, serum levels of melatonin (MT), cortisol (COR), and 5-hydroxytryptamine (5-HT), as well as adverse reactions, were compared across the four groups. Results After treatment, the combination group showed a lower arousal index (AI) and higher sleep efficiency index (SEI) and percentage of rapid eye movement (REM) sleep time to total sleep time (TST) compared with the other three groups (P < 0.05). After treatment, the mini-mental state examination (MMSE) score of the combination group (23.78±1.20) was higher than those of the other three groups (19.65±1.15, 19.70±1.08, 16.36±1.42, F=219.809, P < 0.001). After treatment, MT and 5-HT levels in the combination group were higher than those in the other three groups, while COR level was lower than those in the other three groups (P < 0.001). No statistically significant difference in the incidence of adverse reactions was observed among the four groups (P=0.309). Conclusion Auricular therapy combined with estazolam effectively improves sleep quality, enhances cognitive function, and modulates MT, COR, and 5-HT levels, making it a promising treatment for patients with senile dementia and sleep disorders.
- Senile dementia /
- Sleep disorder /
- Estazolam /
- Auricular therapy /
- Sleep architecture /
- Cognition

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表 1 4组老年性痴呆并睡眠障碍患者治疗前后睡眠结构比较(x±s)

Table 1. Comparison of sleep architecture among the four groups of patients with senile dementia and sleep disorders before and after treatment (x±s)

组别	例数	AI(次/h)
组别	例数	治疗前	治疗后1周	治疗后2周	治疗后4周	治疗后8周
耳穴A组	30	27.53±6.94	24.15±5.59^a	20.33±5.80^a	18.27±4.33^a	17.29±4.57^a
耳穴B组	30	28.11±6.53	23.84±6.14^a	19.86±5.79^a	17.72±5.63^a	16.94±5.11^a
艾司唑仑组	30	27.69±7.01	21.27±6.53^a	18.54±6.08^a	16.74±5.63^a	14.38±4.02^ab
联合组	30	28.25±6.81	20.18±6.49^a	16.40±5.86^abcd	14.88±5.17^abc	13.76±3.98^abc
F值		0.078	3.920	3.640	3.268	6.261
P值		0.972	0.010	0.015	0.024	0.001

组别	例数	SEI(%)
组别	例数	治疗前	治疗后1周	治疗后2周	治疗后4周	治疗后8周
耳穴A组	30	58.73±5.68	63.38±5.91^a	69.83±5.58^a	73.35±6.21^a	76.49±5.52^a
耳穴B组	30	59.11±5.49	64.68±6.18^a	70.34±5.92^a	73.91±6.07^a	78.14±5.08^a
艾司唑仑组	30	57.99±6.08	67.19±6.32^ab	71.14±6.18^a	74.84±6.25^a	80.36±6.37^ab
联合组	30	58.36±5.53	69.91±5.80^abc	75.41±6.39^abcd	77.98±6.08^abc	85.68±6.26^abcd
F值		0.264	8.898	7.305	4.595	18.783
P值		0.851	＜0.001	＜0.001	0.004	＜0.001

组别	例数	REM(%)
组别	例数	治疗前	治疗后1周	治疗后2周	治疗后4周	治疗后8周
耳穴A组	30	12.39±3.63	14.33±3.28^a	17.53±3.22^a	18.82±3.33^a	19.51±3.61^a
耳穴B组	30	12.55±3.18	14.42±3.09^a	17.71±3.39^a	18.69±3.56^a	20.04±3.71^a
艾司唑仑组	30	13.07±2.52	15.63±3.85^a	17.15±3.77^a	19.74±3.52^a	21.01±2.24^a
联合组	30	12.91±2.75	18.47±3.81^abcd	19.55±4.05^abd	21.47±3.96^abc	22.93±2.17^abc
F值		0.362	12.641	3.343	5.430	9.988
P值		0.780	＜0.001	0.022	0.002	＜0.001
注：与同组治疗前比较，^aP＜0.05；与耳穴A组比较，^bP＜0.05；与耳穴B组比较，^cP＜0.05；与艾司唑仑组比较，^dP＜0.05。

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表 2 4组老年性痴呆并睡眠障碍患者治疗前后认知功能比较(x±s，分)

Table 2. Comparison of cognitive function among the four groups of patients with senile dementia and sleep disorders before and after treatment (x±s, points)

组别	例数	MMSE		t值	P值
组别	例数	治疗前	治疗后	t值	P值
耳穴A组	30	16.07±1.04	19.65±1.15	12.646	＜0.001
耳穴B组	30	15.84±1.57	19.70±1.08	11.095	＜0.001
艾司唑仑组	30	15.91±1.66	16.36±1.42^ac	1.128	0.264
联合组	30	16.36±1.42^ab	23.78±1.20^abc	3.600	0.001
F值		1.123	219.809
P值		0.343	＜0.001
注：与耳穴B组比较，^aP＜0.05；与艾司唑仑组比较，^bP＜0.05；与耳穴A组比较，^cP＜0.05。

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表 3 4组老年性痴呆并睡眠障碍患者治疗前后MT、COR、5-HT水平比较(x±s)

Table 3. Comparison of MT, COR, and 5-HT levels among the four groups of patients with senile dementia and sleep disorders before and after treatment (x±s)

组别	例数	MT(pg/mL)		COR(μg/L)		5-HT(ng/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
耳穴A组	30	28.07±3.04	33.01±5.56^a	238.75±31.28	203.69±25.33^a	84.69±12.46	101.68±11.18^a
耳穴B组	30	28.31±4.38	33.58±5.32^a	237.69±35.42	201.70±23.22^a	83.91±13.27	101.94±12.25^a
艾司唑仑组	30	27.84±2.57	28.98±3.31^bc	239.07±32.56	211.76±20.39^a	84.55±11.09	90.64±12.33^abc
联合组	30	27.77±4.49	36.72±5.86^abcd	238.16±37.79	183.61±19.35^abcd	85.14±12.81	122.36±14.26^abcd
F值		0.188	12.870	0.010	10.516	0.077	40.964
P值		0.905	＜0.001	0.999	＜0.001	0.973	＜0.001
注：与同组治疗前比较，^aP＜0.05；与耳穴A组比较，^bP＜0.05；与耳穴B组比较，^cP＜0.05；与艾司唑仑组比较，^dP＜0.05。

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表 4 4组老年性痴呆并睡眠障碍患者不良反应发生情况比较[例(%)]

Table 4. Comparison of the occurrence of adverse reactions among the four groups of patients with senile dementia and sleep disorders [cases (%)]

组别	例数	头晕	乏力	恶心呕吐	口干	合计
耳穴A组	30	1(3.33)	0	0	0	1(3.33)
耳穴B组	30	0	0	0	0	0
艾司唑仑组	30	1(3.33)	0	1(3.33)	1(3.33)	3(9.99)^a
联合组	30	1(3.33)	1(3.33)	1(3.33)	0	4(9.99)^a
注：4组不良反应发生率比较采用Fisher精确检验，P=0.309;与耳穴B组比较，^aP＜0.05。

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